GU system

Question 1

Treponema pallidum

• gram negative spirochete
• obligate internal parasite
• Rabbits used as animal model

Answer 1

The syph

Great imposter, signs and sx look like a lot of other things

Question 2

Virulence of treponema pallidum

Answer 2

(syphilis)
- Fibronectin coat is antiphagolytic

Lesions are primarily the result of the inflammatory response

Question 3

Chancre appears

Local multiplication and dissemination to nearby lymph nodes

Answer 3

Primary syphilis

-Syphilis chancre is the principal lesion of primary syph

Question 4

Maculopapular rash
Mucosal warty lesions - condylomata lata in 1/3 of pts
Immune complexes form in anteriolar walls

Answer 4

Secondary syphilis

Question 5

Neurosyphilis (cortical degen, etc)
Cardiovascular syphilis (AAA)
Granulomata (gummas) in any tissue

Answer 5

Tertiary syphylis

Question 6

Hutchinson’s Triad
-Notched incisors
Interstitial keratitis
8th nerve deafness

Answer 6

Congenital syph

can also cause lesions, nasal obstruction, osteitis of nasal bones

Question 7

How to dx syph

Answer 7

Treponemal test (specific serology)
Nontreponemal test (nonspecific serology test, screening for cardiolipin flocculatio)
Darkfield microscopy

Question 8

Virulence factor of neisseria gonorrhea

gram neg diplococcus w/ kidney bean cells

Answer 8

Plasmid - chromosome mediated resistence to penicillins, tetracylcines, spectinomycin, fluoroquinolones

Question 9

Critical step in gonarrhoeae pathogensis

Answer 9

attachment of epithelia pili and surface proteins

Question 10

Complications of gonnorhea

Answer 10

1) Various local effects (cervicitis, urethritis and d/c)
2) Acute salpingitis or pelvic inflammatory disease (PID)
3) Disseminated Gonococcal Infection (DGI) - arthritis/purulent arthritis, dermatitis

Question 11

Gold standard to dx gonarrhea

Answer 11

Nucleic acid amplification

Question 12

Chlamydia trachomatis

can also cause PID

Answer 12

Obligate intracellular bacteria

gram neg, require host ATP, elementary body, reticulate body

Question 13

Lymphogranuloma venerum

Answer 13

Caused by serotype of Chlamydia trachomatis

Question 14

Gold standard of dx of chlamydial infections

Answer 14

isolation in cell culture

-Noncultural test avail: nucleic acid probes are very sensitive

Question 15

Main resevoir is genital tract of sexually active
Present in >80% of people who boned more than 3 people
Responsible for 50% of nongonococcal, nonchlamydial urethritis in men
Cause of chorioamnionitis and postpartum fever in women

Answer 15

Ureaplasma urealyticum

Question 16

Categories of vaginitis:

Trichomonas tenax

Answer 16

commensal in the mouth

Question 17

Categories of vaginitis:

Trichomonas hominis

Answer 17

Commensal in the intestine

Question 18

Categories of vaginitis:
Trichomonas vaginalis
yellow-grey d/c

Answer 18

Cause of STD
(flagellated protozoan)
Extracellular anaerobe

Question 19

Bacterial Vaginosis

pH 5-6 w/ presence of CLUE CELLS

Answer 19

NOT AN STI
Caused by overgrowth of opportunistic pathogen
Fishy odor, homogenous secretions (grey d/c)

Question 20

Haemophilus ducreyi

Answer 20

CHANCROID

Question 21

Odor-less, thick, WHITE, frothy d/c

Itching, burning during vag activities

Answer 21

Vaginal candidiases

-treat with Miconazole or oral fluconazole

Question 22

Candida albicans virulence

Answer 22

Germ tube is more adhesive than yeast cell

Question 23

Dx of candida

Answer 23

-Direct microscopic exam:
Large gram + cells
Hyphae, pseudohyphae, yeast
-Culture to see germ tubes

Question 24

Soft chancre of Chancoid

-bleeds readily, lacks induration

Answer 24

3-5 days post infection
Vesicle/papule that progresses quickly to pustulation and ulceration
Progressive enlargement and multiple ulcers

Question 25

Lower abd pain
Abnormal vag d/c
Painful sex
Painful, irregular menstruation
Fever, chills
Scarring

Answer 25

Pelvic inflam disease (PID)